Progress in implementing the Stop TB Strategy and the Global Plan to Stop TB, 2006-2015 Update of the Working Group on MDR-TB Thelma Tupasi, Chair of Working.

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Presentation on theme: "Progress in implementing the Stop TB Strategy and the Global Plan to Stop TB, 2006-2015 Update of the Working Group on MDR-TB Thelma Tupasi, Chair of Working."— Presentation transcript:

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Progress in implementing the Stop TB Strategy and the Global Plan to Stop TB, 2006-2015 Update of the Working Group on MDR-TB Thelma Tupasi, Chair of Working Group on MDR-TB From DOTS to the Stop TB Strategy Building on Achievements for Future Planning Meeting of 22 High Burden Countries and Core Groups of the Stop TB Partnership 30 October 2006, La Maison des Polytechniciens, Paris, France

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Outline Goal of the Global Plan 2006-2015 –Launched Jan, 2006 –To enroll on treatment 800,000 MDR-TB patients from 2006 to 2015 MDR-TB in the new Stop TB strategy –Launched March 2006) –To mainstream management of MDR-TB in TB control programmes ensuring access to rational treatment for ALL cases diagnosed with MDR-TB

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Outcome of the Fifth Working Group meeting, May 12, 2006, Atlanta, US Four major challenges to scale up MDR-TB management were identified -Political commitment at country level and resource mobilization -Human resources -Capacity to diagnose all cases of MDR-TB -Drug management of second-line TB drugs

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Challenge 1: Increased and sustained political commitment to scale-up sound TB control programmes Two growth projections for scaling up MDR-TB management

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Challenge 2: Human resources Limited number of consultants trained and experienced in assisting on MDR-TB managmentLimited number of consultants trained and experienced in assisting on MDR-TB managment Quantity of properly trained human resources needed for scaling up MDR-TB management at country level is unknownQuantity of properly trained human resources needed for scaling up MDR-TB management at country level is unknown

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Outcome of the Fifth Working Group meeting, May 12, 2006, Atlanta, US Revitalize the Working Group in order to face these challenges: -To create several subgroups within the WG: - Resource mobilization and advocacy - Research - Drug management - Focal person on laboratory needs for MDR-TB management - Infection control (created in October 2006, after the meeting of the WHO Global Task Force on XDR-TB). -To produce an operational plan to scale up MDR-TB according to the Global Plan and the emerging challenge of XDR-TB (underway)

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Progress in addressing the challenges for operationalizing the Strategic Plan of the WG Sustained commitment to scale up –Business plan for the GLC developed by WHO Working Group Secretariat thanks to generous support of USAID –Board of the GFATM agreed to fund GLC operations under a cost-sharing scheme. First disbursement expected in 2007. –UNITAID gave green light for funding second- line TB drugs for MDR-TB management, operationally through GFATM and directly through GLC

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Major progress in the political commitment to manage MDR-TB in several HBCs China : GFATM approved pilot project for 4,000 patients India: WHO Guidelines for programmatic management of drug resistant TB adapted First application for MDR-TB management in two states reviewed by GLC 1 st November, 2006 Plan of at least one MDR-TB project in 20 states by 2010 Russia: Project to treat 7,500 MDR-TB patients in 12 oblasts approved by GFATM. Ten applications under review/ to be approved by the GLC. Major progress in laboratory capacity to diagnose drug susceptibility testing. Eight high burden TB countries: GLC-supported Programmatic MDR-TB management

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Progress in addressing the challenges for implementing the Global Plan and new Stop TB strategy Laboratory capacity –To be reported by the DOTS expansion Working Group –expansion of the SRL –planned training courses for FLD/SLD DST in conjunction with the SCLS –Drug Resistance Survey

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no data estimates sub-national surveys countrywide surveys Coverage of Anti-Tuberculosis Drug Resistance Surveillance The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.  WHO 2006. All rights reserved

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Drug Resistance Survey in HBCs 11 had carried out nationwide DRS by 2006 –Philippines –Ethiopia –Tanzania Six high burden countries are expanding regional coverage of drug resistance surveys –India, China and Russia have all made major progress –China is planning a nationwide survey in 2007 Indonesia has its first drug resistance survey underway Afghanistan, Nigeria, Bangladesh and Pakistan have no DRS and except Afghanistan plan to carry out surveys.

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Progress in addressing the challenges for implementing the Global Plan and new Stop TB strategy Drug supply –UNITAID agreed to fund the WHO prequalification programme, including all TB drugs –Three major meetings, funded by BMGF, held with manufacturers in Russia and China to promote WHO prequalification, –Update on WHO Prequalification project 7 seven manufacturers applied 13 dossiers submitted 1 manufacturer WHO GMP approved no product yet WHO approved

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Subgroup on Research Officially established in July 06 Several institutions involved: –KNCV (Chair), CDC, PIH, MRC-South Africa, University of Alabama-US, TRC-India –Secretariat in WHO/STOP TB 4 meetings by teleconference and 1 in person (this week) First task: to develop a new prioritized research agenda on drug resistant TB –first draft ready and circulated for comments

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Acknowledge The work of the Working Group and the WHO Secretariat has been possible thanks to the generous funding of: –BMGF –Eli Lilly Inc –DFID –USAID